Surgical guide and methods of use

ABSTRACT

A surgical guide comprising a body including an inner surface that defines a cavity configured for disposal of a surgical instrument. The body further defining an opening communicating with the cavity. A connector disposable with the opening and engageable with a surgical robot. A release is engageable with the connector. Systems, spinal constructs, implants and surgical instruments are disclosed.

TECHNICAL FIELD

The present disclosure generally relates to medical devices for thetreatment of musculoskeletal disorders, and more particularly to asurgical system and method for treating a spine.

BACKGROUND

Spinal disorders such as degenerative disc disease, disc herniation,osteoporosis, spondylolisthesis, stenosis, scoliosis and other curvatureabnormalities, kyphosis, tumor, and fracture may result from factorsincluding trauma, disease and degenerative conditions caused by injuryand aging. Spinal disorders typically result in symptoms including pain,nerve damage, and partial or complete loss of mobility.

Non-surgical treatments, such as medication, rehabilitation and exercisecan be effective, however, may fail to relieve the symptoms associatedwith these disorders. Surgical treatment of these spinal disordersincludes correction, fusion, fixation, discectomy, laminectomy andimplantable prosthetics. As part of these surgical treatments, interbodydevices can be employed with spinal constructs, which include implantssuch as bone fasteners and vertebral rods to provide stability to atreated region. These implants can redirect stresses away from a damagedor defective region while healing takes place to restore properalignment and generally support the vertebral members. During surgicaltreatment, one or more rods and bone fasteners can be delivered to asurgical site. Surgical instruments are employed, for example, to engagethe fasteners for attachment to the exterior of two or more vertebralmembers. This disclosure describes an improvement over these priortechnologies.

SUMMARY

In one embodiment, a surgical guide is provided. The surgical guidecomprises a body including an inner surface that defines a cavityconfigured for disposal of a surgical instrument. The body furtherdefines an opening communicating with the cavity. A connector isdisposable with the opening and engageable with a surgical robot. Arelease is engageable with the connector. In some embodiments, systems,spinal constructs, implants and surgical instruments are disclosed.

In one embodiment, the surgical guide comprises a robotic arm includingan inner surface that defines a channel configured for disposal of asurgical instrument. The robotic arm further defines an openingcommunicating with the channel. A screw is disposable with the openingand engageable with a surgical robot. A rotatable wheel is engageablewith the screw.

In one embodiment, the surgical guide comprises a body including aninner surface that defines a cavity configured for disposal of asurgical instrument. The body further defines an opening communicatingwith the cavity and a slot in communication with the opening. Aconnector is disposable with the opening and engageable with a surgicalrobot. A release is disposable with the slot and engageable with theconnector.

BRIEF DESCRIPTION OF THE DRAWINGS

The present disclosure will become more readily apparent from thespecific description accompanied by the following drawings, in which:

FIG. 1 is a perspective view of components of one embodiment of asurgical system in accordance with the principles of the presentdisclosure;

FIG. 2 is a perspective view of components of the system shown in FIG.1;

FIG. 3 is a cutaway view of the components shown in FIG. 2;

FIG. 4 is a cutaway view of the components shown in FIG. 2;

FIG. 5 is a perspective view of the components shown in FIG. 2, withparts separated;

FIG. 6 is a cross section view of components of the system shown in FIG.1;

FIG. 7 is a perspective view of components of one embodiment of asurgical system in accordance with the principles of the presentdisclosure; and

FIG. 8 is a perspective view, in part cross section, of components ofthe system shown in FIG. 1, with parts separated.

DETAILED DESCRIPTION

The exemplary embodiments of a surgical system are discussed in terms ofmedical devices for the treatment of musculoskeletal disorders and moreparticularly, in terms of a surgical system and a method for treating aspine. In some embodiments, the present surgical system comprises animage guided, robot assisted spinal implant system. In some embodiments,the systems and methods of the present disclosure comprise surgicalrobotic guidance, surgical navigation and medical devices includingsurgical instruments and implants that are employed with a surgicaltreatment, as described herein, for example, with a cervical, thoracic,lumbar and/or sacral region of a spine.

In some embodiments, the present surgical system comprises a surgicalguide connectable with a surgical robot, surgical robotic guidance,surgical navigation and/or medical devices. In some embodiments, thepresent surgical system comprises a surgical guide including a release,for example, a rescue mechanism to release a surgical instrument that isfixed, frictionally fixed, stuck, galled and/or jammed in the surgicalguide. In some embodiments, the release enables the surgical guide to beremoved from the surgical robot. In some embodiments, the releaseconfiguration allows the surgical guide to be replaced with a newsurgical guide and/or reduces component manipulation time during asurgical procedure.

In some embodiments, the present surgical system comprises a surgicalguide including a release, for example, a rescue wheel for a robotic armguide. In some embodiments, the surgical guide includes a rescue wheelthat can be manipulated with a surgical driver or similar surgicalinstrument. In some embodiments, the surgical guide is retained/removedby a surgical driver that is accessed from a front of the surgical guidethrough an opening. In some embodiments, the surgical guide can includea clamp screw to retain a surgical instrument with the guide. In theinstance of a surgical instrument being fixed, frictionally fixed,stuck, galled and/or jammed with an inner surface of the surgical guide,the clamp screw may not be accessible from a conventional access,trajectory and/or front side of the surgical guide to free the surgicalinstrument. In some embodiments, the release of the surgical guideallows the clamp screw to be backed out to free the surgical instrumentalthough there is not conventional access to the clamp screw. In someembodiments, this configuration facilitates removal of the surgicalguide from a surgical robot if a surgical instrument is fixed,frictionally fixed, stuck, galled and/or jammed in the surgical guide.

In some embodiments, the present surgical system comprises a surgicalguide including a release designed to be disposed in a flush orientationwith an outer surface of the surgical guide. In some embodiments, thesurgical guide includes a release that is actuated by a surgicalinstrument that can fit inside slots of a surgical guide, such as asurgical driver.

In some embodiments, the present surgical system comprises a surgicalguide including a rescue wheel that can be manipulated with a surgicaldriver or similar instrument. In some embodiments, this configurationallows a connector, for example, a clamp screw to be released and/orbacked out when there is no access to the clamp screw. In someembodiments, the surgical guide includes through slots for disposal ofthe rescue wheel.

In some embodiments, the surgical guide includes an opening for disposalof a connecting screw that can be accessed from a front trajectoryrelative to the surgical guide. In some embodiments, the openingincludes a pocket so that screw travel is limited and the screwmaintains engagement of the screw to the rescue wheel. In someembodiments, the opening provides a range of movement of the screw inthe opening between a minimum wheel engagement and a full wheelengagement. In some embodiments, the screw protrudes from an outersurface of the surgical guide a selected distance, for example, 1millimeter, for example, from a rear surface of the surgical guide. Insome embodiments, an outside diameter of the rescue wheel is flush to anoutside surface of the surgical guide. In some embodiments, the screwincludes a head having at least one flat surface. In some embodiments,the rescue wheel includes a mating surface that engages a mating surfaceof the screw. In some embodiments, the mating surfaces include flats, asdescribed herein.

In some embodiments, the present surgical system is employed with amethod of performing robotically-assisted spinal surgery. In someembodiments, the method includes the step of delivering posterior spinalinstrumentation through robotic-assisted trajectory alignment tools. Insome embodiments, the present surgical system and method includessurgical robotic guidance having robotic software that performsregistration of a patient anatomy to a three dimensional working spaceof a robot.

In some embodiments, the system of the present disclosure may beemployed to treat spinal disorders such as, for example, degenerativedisc disease, disc herniation, osteoporosis, spondylolisthesis,stenosis, scoliosis and other curvature abnormalities, kyphosis, tumorand fractures. In some embodiments, the system of the present disclosuremay be employed with other osteal and bone related applications,including those associated with diagnostics and therapeutics. In someembodiments, the disclosed system may be alternatively employed in asurgical treatment with a patient in a prone or supine position, and/oremploy various surgical approaches to the spine, including anterior,posterior, posterior mid-line, direct lateral, postero-lateral, and/orantero-lateral approaches, and in other body regions. The system of thepresent disclosure may also be alternatively employed with proceduresfor treating the lumbar, cervical, thoracic, sacral and pelvic regionsof a spinal column. The system of the present disclosure may also beused on animals, bone models and other non-living substrates, such as,for example, in training, testing and demonstration.

The system of the present disclosure may be understood more readily byreference to the following detailed description of the embodiments takenin connection with the accompanying drawing figures, which form a partof this disclosure. It is to be understood that this application is notlimited to the specific devices, methods, conditions or parametersdescribed and/or shown herein, and that the terminology used herein isfor the purpose of describing particular embodiments by way of exampleonly and is not intended to be limiting. In some embodiments, as used inthe specification and including the appended claims, the singular forms“a,” “an,” and “the” include the plural, and reference to a particularnumerical value includes at least that particular value, unless thecontext clearly dictates otherwise. Ranges may be expressed herein asfrom “about” or “approximately” one particular value and/or to “about”or “approximately” another particular value. When such a range isexpressed, another embodiment includes from the one particular valueand/or to the other particular value. Similarly, when values areexpressed as approximations, by use of the antecedent “about,” it willbe understood that the particular value forms another embodiment. It isalso understood that all spatial references, such as, for example,horizontal, vertical, top, upper, lower, bottom, left and right, are forillustrative purposes only and can be varied within the scope of thedisclosure. For example, the references “upper” and “lower” are relativeand used only in the context to the other, and are not necessarily“superior” and “inferior”.

As used in the specification and including the appended claims,“treating” or “treatment” of a disease or condition refers to performinga procedure that may include administering one or more drugs to apatient (human, normal or otherwise or other mammal), employingimplantable devices, and/or employing instruments that treat thedisease, such as, for example, microdiscectomy instruments used toremove portions bulging or herniated discs and/or bone spurs, in aneffort to alleviate signs or symptoms of the disease or condition.Alleviation can occur prior to signs or symptoms of the disease orcondition appearing, as well as after their appearance. Thus, treatingor treatment includes preventing or prevention of disease or undesirablecondition (e.g., preventing the disease from occurring in a patient, whomay be predisposed to the disease but has not yet been diagnosed ashaving it). In addition, treating or treatment does not require completealleviation of signs or symptoms, does not require a cure, andspecifically includes procedures that have only a marginal effect on thepatient. Treatment can include inhibiting the disease, e.g., arrestingits development, or relieving the disease, e.g., causing regression ofthe disease. For example, treatment can include reducing acute orchronic inflammation; alleviating pain and mitigating and inducingre-growth of new ligament, bone and other tissues; as an adjunct insurgery; and/or any repair procedure. Also, as used in the specificationand including the appended claims, the term “tissue” includes softtissue, ligaments, tendons, cartilage and/or bone unless specificallyreferred to otherwise.

The following discussion includes a description of a surgical systemincluding surgical robotic guidance, surgical navigation, surgicalinstruments, spinal constructs, implants, related components and methodsof employing the surgical system in accordance with the principles ofthe present disclosure. Alternate embodiments are also disclosed.Reference is made in detail to the exemplary embodiments of the presentdisclosure, which are illustrated in the accompanying figures. Turningto FIGS. 1-8, there are illustrated components of a surgical system 10.

The components of surgical system 10 can be fabricated from biologicallyacceptable materials suitable for medical applications, includingmetals, synthetic polymers, ceramics and bone material and/or theircomposites. For example, the components of surgical system 10,individually or collectively, can be fabricated from materials such asstainless steel alloys, aluminum, commercially pure titanium, titaniumalloys, Grade 5 titanium, super-elastic titanium alloys, cobalt-chromealloys, superelastic metallic alloys (e.g., Nitinol, superelasto-plastic metals, such as GUM METAL®), ceramics and compositesthereof such as calcium phosphate (e.g., SKELITE™), thermoplastics suchas polyaryletherketone (PAEK) including polyetheretherketone (PEEK),polyetherketoneketone (PEKK) and polyetherketone (PEK), carbon-PEEKcomposites, PEEK-BaSO₄ polymeric rubbers, polyethylene terephthalate(PET), fabric, silicone, polyurethane, silicone-polyurethane copolymers,polymeric rubbers, polyolefin rubbers, hydrogels, semi-rigid and rigidmaterials, elastomers, rubbers, thermoplastic elastomers, thermosetelastomers, elastomeric composites, rigid polymers includingpolyphenylene, polyamide, polyimide, polyetherimide, polyethylene,epoxy, bone material including autograft, allograft, xenograft ortransgenic cortical and/or corticocancellous bone, and tissue growth ordifferentiation factors, partially resorbable materials, such as, forexample, composites of metals and calcium-based ceramics, composites ofPEEK and calcium based ceramics, composites of PEEK with resorbablepolymers, totally resorbable materials, such as, for example, calciumbased ceramics such as calcium phosphate, tri-calcium phosphate (TCP),hydroxyapatite (HA)-TCP, calcium sulfate, or other resorbable polymerssuch as polyaetide, polyglycolide, polytyrosine carbonate,polycaroplaetohe and their combinations.

The components of surgical system 10, individually or collectively, mayalso be fabricated from a heterogeneous material such as a combinationof two or more of the above-described materials. The components ofsurgical system 10 may be monolithically formed, integrally connected orinclude fastening elements and/or instruments, as described herein.

Surgical system 10 can be employed, for example, with a minimallyinvasive procedure, including percutaneous techniques, mini-open andopen surgical techniques to manipulate tissue, deliver and introduceinstrumentation and/or components of spinal constructs at a surgicalsite within a body of a patient, for example, a section of a spine. Insome embodiments, one or more of the components of surgical system 10are configured for engagement with existing spinal constructs, which mayinclude spinal implants such as one or more rods, fasteners, plates andconnectors. In some embodiments, the spinal constructs can be attachedwith vertebrae in a revision surgery to manipulate tissue and/or correcta spinal disorder, as described herein.

Surgical system 10 includes a surgical robotic guidance system having asurgical guide, such as, for example, an end effector 20 connected to arobotic arm 14. The surgical robotic guidance system is employed withone or a plurality of surgical instruments for manipulating vertebraltissue, and for delivering and introducing components of spinalconstructs for engagement with the vertebral tissue. End effector 20includes a release, for example, a rescue mechanism configured tofacilitate removal of end effector 20 from robotic arm 14 if a surgicalinstrument and/or spinal construct becomes fixed, frictionally fixed,stuck, galled and/or jammed within end effector 20.

End effector 20 includes a body 22. Body 22 includes spaced apart arms34. Arms 34 extend axially along body 22, as shown in FIG. 2. Arms 34each include a surface 30 that defines a channel 32. Channel 32 isconfigured for passage of a spinal construct and/or a surgicalinstrument, such as, for example, a surgical driver 100, as describedherein. In some embodiments, arms 34 are flexible to facilitateinsertion of the spinal construct and/or the surgical instrument. Insome embodiments, each arm 34 includes a countersunk surface 37 thatdefines a recess 38. Recesses 38 form a passageway 39 to provide accessto a connector, such as, for example, a clamp screw 36, as describedherein. Passageway 39 is configured to guide and/or direct insertion ofa surgical instrument, such as, for example, a screw driver 150laterally through channel 32 to torque, drive or otherwise engage screw36 to connect end effector 20 with robotic arm 14, as described herein.

Body 22 includes a surface 40 that defines an opening 42. Opening 42extends from surface 30 to a surface 44 of body 20, as shown in FIG. 3.Opening 42 is disposed in communication with channel 32 such that screw36 can be accessed through a portion of channel 32 for engagement withdriver 150, as described herein. Opening 42 is configured fortranslation of screw 36, in the directions shown by arrows A and B inFIG. 6. Opening 42 includes a portion 46, a portion 48 and a portion 50.Portion 46 is disposed in communication with channel 32 such that screw36 can be accessed through channel 32, as shown in FIG. 6. Portion 46 isconfigured for disposal of a head 74 of screw 36, as described herein.

Portion 48 is disposed between portion 46 and portion 50. Portion 48 isconfigured for disposal of a shaft 80 of screw 36. Portion 50 isdisposed in communication with surface 44 of body 22, as shown in FIG.6. Portion 50 is configured for disposal of a mating portion 90 of shaft36. Portion 50 includes a wall 52 that defines a depth X1 of portion 50.Wall 52 is configured to limit translation of screw 36 duringdisengagement of screw 36 from robotic arm 14, for example, as screw 25translates, in the direction shown by arrow A in FIG. 6, as describedherein. Wall 52 limits, resists and/or prevents translation of screw 36to maintain engagement of head 74 with the release, as described herein.

Portions 46, 48, 50 are disposed in axial alignment. Portions 46, 48, 50include diameters configured to accommodate various sizes of portions ofscrew 36. Opening 42 is disposed lateral to channel 32. In someembodiments, opening 42 is disposed at alternate orientations relativeto channel 32, such as, for example, at transverse, perpendicular and/orother angular orientations such as acute or obtuse, and/or may be offsetor staggered.

Body 22 includes a surface 60 that defines a slot 62. Slot 62 isconfigured for disposal of the release, such as, for example, a wheel64, as described herein. Slot 62 is disposed in communication withportion 46 of opening 42 such that screw 36 is engaged with wheel 64, asshown in FIGS. 3-6. Slot 62 includes a square cross sectionconfiguration. In some embodiments, slot 62 may have variousconfigurations including, for example, round, oval, polygonal,irregular, consistent, variable, uniform and non-uniform.

Screw 36 extends between an end 70 and an end 72, as shown in FIG. 5. Insome embodiments, screw 36 is configured as a clamp screw. Screw 36 isconfigured to engage a corresponding mating surface 15 of robotic arm14, to connect end effector 20 with robotic arm 14. Screw 36 includes ahead 74. Head 74 is configured for engagement with a portion of wheel 64such that rotation of wheel 64 simultaneously rotates screw 36 todisengage screw 36 from robotic arm 14, as described herein. In someembodiments, head 74 includes planar surfaces 76 configured for a keyedconnection with wheel 64.

Head 74 includes a socket 78. Socket 78 is configured for engagementwith driver 150 to drive, torque or otherwise connect screw 36 withrobotic arm 14 to assemble end effector 20 with robotic arm 14, asdescribed herein. In some embodiments, socket 78 includes a hexalobegeometry for a mating engagement with a correspondingly portion ofdriver 150. In some embodiments, socket 78 can alternatively include acruciform, phillips, square, hexagonal, polygonal, star cross sectionalconfiguration for disposal of a correspondingly shaped portion of driver150. Screw 36 includes shaft 80 the extends from head 74.

Screw 36 includes mating portion 90 disposed with shaft 80 at end 72.Mating portion 90 includes a surface 92 that is configured forengagement with a portion of robotic arm 14. In some embodiments,surface 92 includes a threaded surface configured for engagement with athreaded surface of robotic arm 14 to facilitate connection of endeffector 20 with robotic arm 14. For example, as surface 92 engages acorresponding mating surface 15 of robotic arm 14, screw 36 draws and/orpulls end effector 20 into connection with robotic arm 14.

Mating portion 90 includes a length X2. Length X2 is greater than depthX1 of portion 50. For example, length X2 is 1 mm greater than depth X1such that mating portion 90 protrudes from surface 50 approximately 1mm, as shown in FIG. 8. In some embodiments, this configurationfacilitates engagement of mating portion 90 with robotic arm 14.

Wheel 64 includes a body 120. Body 120 includes a surface 121. Aplurality of radial members, such as, for example, arms 122 extend fromsurface 121. Arms 122 define a recess 124 disposed between adjacent arms122. Recess 124 is configured for disposal of a surgical instrument,such as, for example, driver 150 to actuate movement, for example,rotation of wheel 64. Wheel 64 is configured to be actuated for rotationwithin slot 62. Arms 122 extend a distance from surface 121 defining adiameter D1 of wheel 64. Surface 60 of slot 62 includes edges 66extending along an outer surface 68 of body 22, as shown in FIG. 4.Edges 66 define a width W1 of slot 64.

In some embodiments, diameter D1 is less than width W1 such that arms122 are disposed within slot 62 to resist and/or prevent accidentalrotation of wheel 64. In some embodiments, diameter D1 is equal to widthW1 such that arms 122 are disposed in a flush orientation with edges 66to resist and/or prevent accidental rotation of wheel 64.

Body 120 includes a surface 130. Surface 130 defines a mating portion,for example, an opening 132. Opening 132 is configured for disposal ofhead 74. Engagement of head 74 with surface 130 facilitates simultaneousrotation of wheel 64 and screw 36. In some embodiments, surface 130defines planar surfaces, for example, flats 134 configured forengagement with surfaces 76 of head 74 in a keyed connection.

In use, driver 150 is engaged with socket 78. Driver 150 is manipulatedto rotate screw 36 into engagement with robotic arm 14. Screw 36 pullsand/or draws end effector 20 for connection with robotic arm 14, asshown in FIG. 6. Driver 100 is disposed with channel 32. In someembodiments, during use, driver 100 may become fixed, frictionallyfixed, stuck, galled and/or jammed with surface 30 of end effector 20thereby preventing access to socket 78. As such, screw 36 cannot bedisengaged from robotic arm via socket 78. To disconnect end effector 20from robotic arm 14, wheel 64 is actuated by insertion of driver 150between arms 122, as shown in FIG. 7. Driver 150 is utilized as a leverto apply a force to arm 122 causing wheel 64 to rotate, in a directionshown by arrow C in FIG. 7. Wheel 64, via engagement of surfaces 76,130, causes screw 36 to rotate out of engagement with robotic arm 14, asshown in FIG. 8. Wall 52 of portion 50 limits, resists and/or preventstranslation of screw 36 out of engagement with wheel 64 to maintain aconnection between wheel 64 and screw 36.

In assembly, operation and use, surgical system 10, similar to thesystems and methods described herein, is employed with a surgicalprocedure, such as, for example, a treatment of an applicable conditionor injury of an affected section of a spinal column and adjacent areaswithin a body. In some embodiments, one or all of the components ofsurgical system 10 can be delivered or utilized as a pre-assembleddevice or can be assembled in situ. Surgical system 10 may be completelyor partially revised, removed or replaced.

In use, to treat vertebrae (not shown), a medical practitioner obtainsaccess to a surgical site in any appropriate manner, such as throughincision and retraction of tissues. In some embodiments, surgical system10 can be used in any existing surgical method or technique includingopen surgery, mini-open surgery, minimally invasive surgery andpercutaneous surgical implantation, whereby the vertebrae is accessedthrough a mini-incision, or sleeve that provides a protected passagewayto the area. Once access to the surgical site is obtained, theparticular surgical procedure can be performed for treating the spinedisorder.

In connection with the surgical procedure, end effector 20 is assembledwith robotic arm 14. Driver 150 is inserted through passageway 39 intoengagement with socket 78 of screw 36. Driver 150 is engaged with socket78. End effector 20 is positioned adjacent robotic arm 14. Driver 150 ismanipulated to rotate screw 36 into engagement with mating surface 15 ofrobotic arm 14. Screw 36 pulls and/or draws end effector 20 intoconnection with robotic arm 14, as shown in FIG. 6.

A bone fastener is connected with driver 100. Driver 100 is insertedinto channel 32 for disposal adjacent the surgical site. Driver 100 ismanipulated via robotic arm 14 to torque, drive or otherwise engage thebone fastener with tissue. During use, manipulation of driver 100 maycause a surface of driver 100 to become fixed, frictionally fixed,stuck, galled and/or jammed with end effector 20 requiring the removalof end effector 20 from robotic arm 14.

Fixation of driver 100 with end effector 20 prevents access to socket 78of screw 36 to disengage end effector 20 from robotic arm 14. Wheel 64is utilized to disconnect end effector 20 from robotic arm 14. Driver150 is inserted between arms 122 to apply a leveraging force to actuatewheel 63, as shown in FIG. 7. Driver 150 applies a force to arm 122causing wheel 64 to rotate, in a direction shown by arrow C in FIG. 7.Surfaces 130 engage surfaces 76 causing screw 36 to rotate out ofengagement with robotic arm 14 to remove end effector 20 and driver 100that was fixed, frictionally fixed, stuck, galled and/or jammed withinend effector 20, as shown in FIG. 8. In some embodiments, an alternateend effector 20 can be attached to robotic arm 14.

Upon completion of a procedure, the surgical instruments andnon-implanted components of surgical system 10 are removed and theincision(s) are closed. One or more of the components of surgical system10 can be made of radiolucent materials such as polymers. Radiomarkersmay be included for identification under x-ray, fluoroscopy, CT or otherimaging techniques. In some embodiments, the use of surgical navigation,microsurgical and image guided technologies may be employed to access,view and repair spinal deterioration or damage, with the aid of surgicalsystem 10.

In some embodiments, surgical system 10 includes an agent, which may bedisposed, packed, coated or layered within, on or about the componentsand/or surfaces of surgical system 10. In some embodiments, the agentmay include bone growth promoting material, such as, for example, bonegraft to enhance fixation of the fixation elements with vertebrae. Insome embodiments, the agent may be HA coating. In some embodiments, theagent may include one or a plurality of therapeutic agents and/orpharmacological agents for release, including sustained release, totreat, for example, pain, inflammation and degeneration.

It will be understood that various modifications may be made to theembodiments disclosed herein. Therefore, the above description shouldnot be construed as limiting, but merely as exemplification of thevarious embodiments. Those skilled in the art will envision othermodifications within the scope and spirit of the claims appended hereto.

What is claimed is:
 1. A surgical guide comprising: a body including aninner surface that defines a cavity configured for disposal of asurgical instrument, the body further defining an opening communicatingwith the cavity; a connector disposable with the opening and engageablewith a surgical robot; and a release engageable with the connector.
 2. Asurgical guide as recited in claim 1, wherein the body includes spacedapart arms that define an axial channel.
 3. A surgical guide as recitedin claim 1, wherein the opening is disposed lateral to the cavity.
 4. Asurgical guide as recited in claim 1, wherein the opening includes afirst portion, a second portion and a third portion.
 5. A surgical guideas recited in claim 4, wherein the portions are axially aligned.
 6. Asurgical guide as recited in claim 1, wherein the connector includes aclamp screw.
 7. A surgical guide as recited in claim 1, wherein theconnector includes a portion configured for connection with the surgicalrobot and a portion configured for connection with the release.
 8. Asurgical guide as recited in claim 1, wherein the connector includes amating surface configured for connection with the surgical robot.
 9. Asurgical guide as recited in claim 1, wherein the connector is moveablewithin the opening for a range of engagement with the release.
 10. Asurgical guide as recited in claim 1, further comprising a slot disposedin communication with a portion of the opening.
 11. A surgical guide asrecited in claim 10, wherein the slot is configured for disposal of therelease.
 12. A surgical guide as recited in claim 1, wherein the releaseis engageable with the connector to facilitate disengagement of theconnector from the surgical robot.
 13. A surgical guide as recited inclaim 1, wherein the release includes a rotatable wheel.
 14. A surgicalguide as recited in claim 1, wherein the release includes a surface thatdefines an opening configured for disposal and engagement with theconnector.
 15. A surgical guide as recited in claim 1, wherein therelease includes flats configured for a keyed connection with theconnector.
 16. A surgical guide as recited in claim 1, wherein therelease includes a plurality of radial members.
 17. A surgical guidecomprising: a robotic arm including an inner surface that defines achannel configured for disposal of a surgical instrument, the roboticarm further defining an opening communicating with the channel; a screwdisposable with the opening and engageable with a surgical robot; and arotatable wheel engageable with the screw.
 18. A surgical guide asrecited in claim 17, further comprising a slot disposed in communicationwith a portion of the opening.
 19. A surgical guide as recited in claim18, wherein the slot is configured for disposal of the rotatable wheel.20. A surgical guide comprising: a body including an inner surface thatdefines a cavity configured for disposal of a surgical instrument, thebody further defining an opening communicating with the cavity and aslot in communication with the opening; a connector disposable with theopening and engageable with a surgical robot; and a release disposablewith the slot and engageable with the connector.